Tis the Season for Gratitude

A morning ritual for me is to take a few minutes and write something that I am thankful for.  At each staff meeting, I go around the table and ask not for what problems we face, but what Positives we want to share with each other.

If you are involved in the Health Care field than you already know that generally we have thankless jobs. Nobody gets up and says I want to go and see a physician, therapist or wheelchair specialist. We glory in our outcomes and success stories whether told or seen through our own eyes. 

This brings me to my point....Life is not perfect or fair, and if we dwell on the negative, and there certainly is a lot of that in the world, then our projection/signal to the world will be reflected in the same light and we will miss the most valuable thing in life.....TIME.

I would encourage you, during this time of year, to reflect on the good in you and your family/friends lives.  Stop judging yourself on what you have not achieved and Celebrate and Appreciate what you have.

Happy Holidays from the Staff at Active Mobility Center.  Carey can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com .

The TEAMS behind your Medical Equipment

Any time you want something done right, you need a team behind you.  Whether it is a medical procedure, a legal matter, or acquiring new equipment- you need a team to ensure that the job is done right.

Seating and Mobility Equipment can be intimidating, and the process painful and confusing.  A team with the knowledge and experience in this area is essential.  There are two teams, the one that helps you select and provide you with your equipment and the one that keeps it working for the equipment's useful life.

The initial team would consist of  you, your physician, a physical, occupational and possibly a speech therapist, your family, caregivers and the equipment supplier. Each of these individuals are crucial in providing information to ensure that the equipment fulfils your needs, and your goals.  You are responsible for helping the team what your goals/desires are for your future, what you need your equipment to do to keep up with your life demands.  Your physician will need to provide a history, and any goals/concerns that they have. The Physical and Occupational Therapist(s) bring information on body posture, functional capability, and expected prognosis.  These clinicians perform a functional assessment and are very involved with the equipment prescription. Your family and caregivers need to voice their concerns about function, equipment and accessibility issues. The supplier brings equipment knowledge and works directly with all involved to help recommend the most appropriate equipment based on all the information that is gathered.

This team works really hard to trial and document the equipment, which is sent to the insurance for consideration.  This team works with the insurance provider to provide any additional documentation that is needed to receive an approval. On delivery, the Equipment supplier works with the user, the clinicians, and the caregivers to adjust and optimally fit the equipment.

Once the equipment is used on a daily basis, the technical service department because the support team to help maintain, adjust and repair the equipment; until such time the equipment is worn out and needs to be replaced. 

In the event that the equipment no longer fits, or there is a change of condition, the user is referred back to the physician and clinical team to review the equipment and make any recommendations on changes needed.

This article was written by Carey J. Britton, ATP/SMS, CRTS at Active Mobility Center. Active Mobility Center is a Seating and Mobility Specialty company located in Pompano Beach, Florida. Carey can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com .

Understanding A Small Moment in the Life of a Wheelchair User

I was watching behind the scenes of Jamie Fox playing Ray Charles, and he didn't become the character until the director had his eyes sealed with a prosthetic.  Until he was able to experience life without vision, he didn't understand what it was truly like.

Similarly, the public has not realization on what a wheelchair user goes through both physically and emotionally. I will not pretend to understand or know everything; but do have each staff member working with us spend quite a lot of time sitting in and using the equipment we provide and try to perform daily tasks.  This is an eye opening process, and even though they can get out of the equipment; they learn a valuable lesson.

A few years ago the PVAF held a bowling event where everyone had to bowl from a wheelchair or scooter device.  It was a great opportunity not only to raise money; but awareness. 

Any time we as a group can glimpse at the lives of others it builds a understanding and brings down barriers.

This article was written by Carey J Britton, Seating and Mobility Specialist at Active Mobility Center. He can be reached at 954-946-5793 or cbritton@wheelchairguys.com.

What's More Important Wheelchair Brand or Wheelchair Configuration?

The Wheelchair Frame or the Wheelchair Configuration?

It is important to understand that when you are using a wheelchair, scooter or powered wheelchair; the seating and frame configuration is more critical than the brand of chair that you own/buy.  As an expert in the industry, I find most consumers coming to me with questions on which brand; Quickie, Invacare, Colours, Permobil or Tilite wheelchairs and which is the best.  If you had asked me a few years ago, I may have had a preference, however today through innovative new technology there are only subtle differences.

The wheelchair frame is important, however the configuration of the frame and the seating is much more critical to the function and well being of the user.  As I am sure you will agree, many wheelchair users posture is less than perfect in their wheelchair; even if the chair brand is a good one.  You can have the best of equipment but if it isn't configured properly it is only contributing to the problems you are facing.

How Can I Improve My Posture & Function? 

/As a professional, when I am asked this question, I suggest they see their physician or their physical/occupational therapist.
Their medical professionals may have insight on why they sit the way that they do. It is good practice for any wheelchair user to use a team of people to help solve these issues. 

Assuming their physician clears the user with no physical limitations, we can work to improve posture and positioning.  This may require only an adjustment; or it could require new seating and positioning equipment or an entirely new device.

The goal is aways to start at the pelvis. The human pelvis is where everything is attached, and requires the greatest attention in sitting. The goal is to place the pelvis in as close to neutral position as possible. Of course for some individuals having the pelvis anteriorally tilted or posteriorally tilted will be necessary. A stable pelvis is the route of function, which equates to mobility and quality of life. The seating supports are also very critical in the positioning and stabilization of the pelvis.

The position of the lower extremities (legs/feet) are important to consider, as they are tied to the pelvis and require support and positioning.  The angles at the feet/ankles,  the angles at the knee and the angle of the hips are very important for positioning as well as for function and mobility.

What DO I  Need to Know ?

If you are are a wheelchair user, you need to understand that how you are positioned in your wheelchair frame, the orientation, and the seating supports will improve your posture, improve your stability, improve your function and improve your health.  Failure to consider this early, when he body is flexible can result in contracture and deformity that can increase life complications. 

Who Can Help Me?

There is a seating and mobility specialist in nearly every community. This may be a physician, therapist or RESNA or NRRTS. These organizations maintain a list of practicing experts who can assist you with all your equipment needs. You should find and align yourself with a team who can monitor and make recommendations as your body changes or when you are confronted with an obstacle.

This article was written by Carey J. Britton, ATP/SMS, CRTS to offer general but important information on wheelchair configuration and seating.  Carey is the resident Seating and Mobility Specialist for Active Mobility Center. He can be reached at cbritton@wheelchairguys.com or (800) 326-4463.

Is a Wheelchair is a Medical Failure ?

I was appalled when I first heard that a Wheelchair is a Medical Failure. Apparently in the Medical Model, it is taught that when resorting to long term use of wheelchairs and other mobility devices, that you have given up.

It is not surprising then, that the community perspective is that a person in a wheelchair is lame, an invalid, or handicapped....all negatively describing a person's DISABILITIES. This is also why that Prosthetics are much more acceptable, even when they are not as functional.

It may come at a surprise, but mobility equipment is provided not for mobility or independence but to reduce the medical costs associated with an individual stuck in bed. It is clear that a bed bound individual will cost the Health care system more than what it costs to get them out of bed.  Cushioning and Positioning is not for the comfort of a wheelchair user, but to reduce injury, reduce skin breakdown and to reduce contracture and deformity.  We look at this equipment to increase function, independence and quality of life, but the funding sources (all based on Medicare's policy) does not.

Therapy services for individuals with long term mobility challenging conditions are limited. It seems that the Medical Model if there is not documented gain in function then therapy services are not needed. After spending over 20 years in this industry, the question should be without therapy services how much loss will occur. 

Medicare who creates Medical and Equipment Standards, approves equipment based on use within the home and has little flexibility about looking at equipment for recreation and vocation. 

In my 20+ year career, I have seen huge change.  I am concerned with the changing policies that more equipment users need to voice their challenges and their victories.  Not unlike the Women's Rights Movement, where women didn't have a voice, and where they were stuck in the home; equipment users deserve the same. 

If this article has moved you, I encourage you to look at www.usersfirst.org, or www.ncart.us and get involved, share your story, and be heard.  You can reach Carey Britton, Seating and Mobility Specialist at Active Mobility Center at 954-946-5793 or cbritton@wheelchairguys.com .

Event Management at Active Mobility Center

Sitting here looking at the date of December 1st, 2013, I am scratching my head wondering where this year has went.  Reflecting over the last 11 months, one of the best changes we have made is managing tasks and events...and not time.

We all have the same 24 hours in a day, and some people are able to accomplish much more within these hours...why?  At Active Mobility Center we use task management instead of time management. We cannot slow down time, but we can manage our tasks better to improve our efficiency and accomplish more.

Making a Plan

Any time we want to change something, we cannot leave it to our memory, but must write it down.  We must make it a commitment and arrange our day to ensure we carve out a space to work on this.  Without a plan any goals or dreams you have cannot ever be accomplished. 

It is effective to write down what your desired destination is in five years. If your destination is too large, it make feel unattainable.  Taking that 5 year goal, and breaking it into five year pieces, you can break it down to where you need to be each year to get there, and then breaking that down to quarters of the year will make it seem attainable.

Writing It Down

Whether it is a to-do list, a 5 year plan, or 90 day goals; it needs to be written down so you can review it on a regular basis to see where you are and what you need to do next. Many people find it helpful to have a  on-going list of tasks to complete, and taking that list and picking 2-3 items each day to complete. This way each day there is a feeling of winning, instead of looking at your final destination and giving up.

Not Just about Business

These ideas can be used by anyone to improve their efficiency, and to accomplish more of what we set out to do.  Once you put this in motion, it develops into a habit and your life is changed forever.
 

The thoughts and ideas listed are that of Carey Britton, with Active Mobility Center. Carey can be reached at (954) 946-5793 or cbritton@wheelchairguys.com .

Happy Thanksgiving from All of us at Active Mobility Center

It never ceases to amaze me on how fast the last quarter of the year goes by.  I am sitting here reflecting on 2013, and how things have changed.  Thanksgiving for many is their favorite holiday, certainly not due to the commercialism; but because it is a time to spend with family and friends. I find myself seeing more advertisements for the December Holidays, where society is trying to take away any enjoyment of Fall and Thanksgiving.

I am reminded that Thanksgiving is much more than sitting around the table eating Turkey and watching football. It is a time to be thankful for your family, your friends and where you are with your life.  Even if for a day, to step back in time, and reduce all of the distractions and to re-engage with your friends and family and to be grateful for what we have.  The personal relationships are much more valuable than what is going on with facebook, twitter, and the rest of the digital world.

At Active Mobility Center, we are grateful for all the support from our staff, our customers, our business partners, our referral sources, and the funding sources who enable our staff and it's abilities to make every day independence day.  We believe with Thanksgiving occurs every day of the year.

Any questions, or comments can be directed to, Carey Britton, Seating and Mobility Specialist for Active Mobility Center. He can be reached at 954-946-5793, or at cbritton@wheelchairguys.com .

One More Reason to be Angry with Medicare !!

If you are a user of DME and Mobility Equipment, here's another reason for you to be upset !It's official, Medicare has reclassified Tilt in Space manual wheelchairs, powered assist wheels, and pediatric wheelchairs as capped rentals.  This was released late on Friday....Happy Thanksgiving?

This will, if implemented, certainly affect access and the quality of equipment provided to people with significant special needs. 

Tilt in Space Wheelchairs- many of you know that tilt in space wheelchairs, are specialty wheelchairs, that require a face to face visit, a specialty evaluation from a therapist and an ATP to be involved. These tilt in space wheelchairs involve specialty seating and positioning equipment and require a high level of technical experience from the equipment supplier to ensure the most appropriate equipment is provided.

The costs associated with having ATPs and Technicians to provide and support for this equipment have now tipped the scales.  Tilt in space wheelchairs are near $3000, with all the documentation, and expenses required to provide this equipment, suppliers will now be forced to accept ~ $250/month.  How many equipment suppliers can wait 7-9 months to recoop their investments on wheelchairs that are custom ordered and fitted to a individual?

Most specialty providers have already been excluded out of  much of the DME program (Durable Medical Equipment), where the new round of competitive bidding recently gave access to all standard wheelchairs to winning bidders.  This was a huge blow, as the winning bidders of this equipment do not (in most cases) have ATP certified technicians, leaving these companies to determine which wheelchair is right for which person. In the past month, we have already heard nightmares about people receiving inappropriate equipment, which is negatively affecting lives and function.  Tilt in Space wheelchairs in the rental market will cause suppliers to rent used equipment, or inferior equipment to fit an allowable and not the person.

Powered Assist Wheels- are a low utilized technology allowing powered assist wheels to be added to a manual wheelchair when a user has difficulty propelling a manual wheelchair. These powered options are near $5,000.00, suppliers will likely not be able to afford providing and waiting nearly a year to recoop their capital investment.

Pediatric Wheelchairs- are generally not covered under Medicare with few exceptions. Any individuals who fall into this area may lose access entirely.

I encourage you to watch this development closely and speak out before it is too late.  Medicare has already ruined much of DME program. What happens with Medicare becomes standard with private insurance and medicaid. Babyboomers should be very scared, as they are watching services disappear.

With Medicare's war on DME, it is curious to see what is left in 2014.  There are less than 50% of the quantity of providers of this equipment only 2 years ago.  This new round of bidding that goes into affect January 1st will likely reduce the number of providers again by 40-50%.  Choice of equipment and choice of a provider are rapidly ending as providers who have the knowledge, experience, and infrastructure are not able to compete.

This article was provided by Carey Britton, Seating and Mobility Specialist for Active Mobility Center. He can be reached at 954-946-5793 or cbritton@wheelchairguys.com.

Who knew how large the Boating Beach Bash was?

6th Anniversary

For the past several years, Active Mobility Center has been an exhibitor for this event, held at Spanish River Park each spring. This event which started off as an offering of boat rides for people with disabilities; has become a premier event in South Florida. I was fortunate to have been invited to a planning meeting this week for this event, and not only found some amazing people involved; but had no idea how large this event had become.   This years event is shaping up to be the largest and best yet. Each year, this event is busier, but I was unaware that the attendance was over 5000 people in one day.

There are some real surprises added to the 2014 event, that you will not want to miss.

Mark your calendars for:
      Boating Beach Bash
      Spanish River Park, Boca Raton
      March 22nd from 10am to 3pm
     

This article was provided by Carey Britton, Seating and Mobility Specialist at Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .

Active Mobility Center Supporting 10th Year Anniversary for Wheels for Kids

Debra and I were greatful to be invited to the Celebration last night to support the 10th Anniversary of Wheels for Kids.  This great organization, located in Palm Beach County, supports children with special needs who fall through the safety net.  Denise Jungbert, Founder, has a goal to provide wheeled mobility to children with mobility impairments live a better, higher quality life.

Last night, a celebration was held at Buccan in Palm Beach. We are fortunate to have a small part supporting this community asset. 

Carey Britton, Seating Specialist for Active Mobility Center can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .

Open Communication Building a Better Community

In a time were Social Media seems to be taking over, I was fortunate to have spent several hours face to face with the Broward CIL leadership group led by Danny Murphy.  The BCIL leadership program, spends time visiting community partners to learn about what they do, and at the same time bring a different view on how businesses and organizations are perceived.

I was excited, as I had received a preliminary email last week on some questions that were raised from the group.  I had answered these questions, and provided some background information of the history, mission, vision and challenges faced both locally as well as an industry to help build a foundation, to allow us to get deeper in conversation about what the community is looking for.

After a tour, we met in the conference room where we discussed the history, vision and purpose of the company.  We discussed what we feel separates us from our competition; and why we continue to do what we do.  I believe the group has a much better understanding on how the system works, and what increased pressures and requirements we face over a more traditional business.  I believe we were able to share some valuable resources that can benefit the group and the community.

Unlike Social Media, there were no boundaries or hiding behind a computer; we were looking for feedback, suggestions, what their ideal CRT Company (Complex Rehab Technology) looks like, what challenges / obstacles they face, and how we can be a more valuable part of the community.

The group was able to ask questions, and offer their perception, and what they are looking for in an equipment company.  The exchange provided us with several ideas, and much to discuss with Active's staff on setting up a schedule in which to implement some of these suggestions.

We Thank Danny Murphy, and the members of the Leadership Group for taking the time to learn about what we do, and helping our company improve.

Any questions can be directed to Carey Britton, Seating Specialist for Active Mobility Center. He can be reached at 954-946-5793 or cbritton@wheelchairguys.com .

Happy Veterans Day from Active Mobility Center

Each year, in the US we Celebrate Veteran's Day. For some it is a day off from school or work; but for others it is the appreciation of those who have served to make our country what it is today. We take many freedoms for granted, and forget that they came at a huge price.   

I would ask that on Monday November 11th, we each take a quiet moment and appreciate and celebrate what we have.

 If you have the chance Thank a Veteran for all that they did and what they continue do to maintain the United States of America.

If you want to comment, you may do so to Carey Britton at Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .

Krabat Jockey Plus

This new product to the US is a Hi-Lo base that provides kids with balanced, contoured support and lets them interact with the world- at whatever level they'd like, where every they like.. The angle-adjustable sadldle seat abducts the hips and puts the pelvis into a neutral position, encouraging an active seating position. The upper body is aslo well supported with high backrest, adjustable lumbar support, and adjustable side supports.

Saddle seats offer a dynamic, balanced position and are expecially well suited for children with tight or spastic hip adductor muscles.

Features/Benefits

* It makes it easy for kids to interact with teh world and get a handle on new skills

* For Kids between 2-7 and up to 132 lbs

* Folds down and fits into carrying bag for easy transport

* All major joints in the lower extermities become centered. This promotes natural muscle tone and length, and helps to rpevent muscle contractures, hip pain and subluxations.

* Dynamic postural control allows child to move freely.

This product was shared by Carey Britton, Seating and Mobility Specialist at Active Mobility Center. He can be reached at (954) 946-5793, or cbritton@wheelchairguys.com.

Wheelchair Clinic at Broward Center for Independent Living

This past Friday, November 1st, we held our 2nd Wheelchair and Seating Clinic hosted by Broward Center for Independent Living, Nova University and Active Mobility Center.  The clinic is held the first Friday of each Month; offering education, adjustments and recommendations on adatpive and rehab equipment used by people with Mobility Impairments within our community.

This clinic was started with the concern that many people do not know much about their equipment or the importance of seating and positioning. Through the development of a progam with Adrienne Lauer, OT and professor at Nova University and Carey Britton, Seating/Mobility Specialist at Active Mobility Center, we have started something special.

This month, we met with 11 individuals to help maintain and improve their seating and mobility.  We expect to expand these services and are constantly listening to attendee's on how we can improve our program.

For more information or to schedule an appointment, please contact Brian at BCIL  954-722-6400.

This article was provided by Active Mobility Center which is located in Pompano Beach Florida, and questions or comments can be directed to (954) 946-5793 or cbritton@wheelchairguys.com .

Danny Murphy and CinemAbility 2013

Danny Murphy in Permobil C500 

The last Screening of CinemAbility in South Florida came to a close on Saturday November 2nd in Ft. Lauderdale at the Cinema Paradiso.   Thanks to all that came out to support the Film and the community. The event was a fund raiser for the Broward Center of Independent Living.  CinemAbility is a documentary of Disabilities in Silent films to modern day Silver Screen and TV. 

Danny Murphy, an Associate Producer with the project was on site to introduce the film and answer questions the audience had.  The Project was Directed by Jenni Gold, and was well attended in Ft. Lauderdale during the Ft. Lauderdale Film Festival. 



Auto Mobility and Active Mobility

Active Mobility Center along with Permobil and Auto Mobility were the Sponsors for this event.  An after party was held outside the Cinema to further discuss the film, to network and bring the community together.

This is a good piece of film that should eventually be televised, and can be really good for School education.

This Article was written by Carey J. Britton, Seating and Mobility Specialist at Active Mobility Center, he can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com.

What is Complex Rehab Technology ?

CRT (Complex Rehab Technology) is the newest term, developed over the last few years to describe specialty equipment that which is more involved than basic  DME (Durable Medical Equipment). As you may know DME encompasses everything from disposables  to custom wheelchairs and Orthotics/Prosthetics. You may wonder why a new term was created if it is part of DME? 

Invacare Rear Drive Powerchair

For years, DME vendors have been given a bad name, with a few bad companies taken advantage of the system and many times committing fraud.  CRT was born, when Medicare created the Competitive bidding process and they didn't understand the level of involvement with Specialty Seating and Equipment. After much work from the Rehab industry, some specialty equipment was exempt from the competitive program; including ultra light weight wheelchairs, tilt in space wheelchairs, and group 3 powered wheelchairs.  Medicare, who sets precedent for Medical Equipment to all funding sources, accepted that the skill level and expertise in providing this level equipment was above the typical DME provider.

Since that time, NRRTS ( National Registry of Rehab Technology Suppliers ) and NCART ( National Coalition of Assistive and Rehab Technology ), has been lobbying Congress to further separate Complex Rehab equipment from DME.  It is understood that there is a value for this equipment provided and that there needs to be increased safeguards, and education from individuals providing this level of equipment. If  this industry is not protected, and the value shown, it will disappear in the upcoming years.  The average age of Rehab Technicians are late 30's, with most over 40, and few new people learning this trade.

Carey Britton

 With the baby boomers aging, we will need more specialists  involved; helping match proper equipment for seating and mobility needs.  A further issue causing challenge, is that there are fewer physician and therapists specializing in this field; leaving more pressure and expectations on the Seating and Mobility Specialists.   Although the Seating and Mobility Specialist is a critical component in the team that provides and supports these services; the clinician is  the gatekeeper, and we need more clinicians  to step up become community leaders. 

In order to ensure  good outcomes, we continue to progress in this industry with increased credentials, increased education, and increased safeguards to protect patients.  Our industry needs to continue to educate the allied services to become more involved in the team that is required to improve seating, function and overall satisfaction.

This article was written by Carey Britton, Seating and Mobility Specialist at Active Mobility Center. He can be reached for comment at 954-946-5793 or at cbritton@wheelchairguys.com  .

 

Active Mobility Previews CinemAbility.



Carey and Jenni

I was lucky enough to be invited to the screening of CinemAbility on 10/19/2013 at the Muvico at Pompano Beach. CinemAbility is a documentary of Disability on the Silver Screen from the the early silent films  through the present day.  Jenni Gold, Director created an amazing journey with viewer, with a star studded cast. Our local celebrity Danny Murphy had several parts helping to show the importance of using actors with disabilities in TV and in the Movies to help bring more awareness  and realism.  Jenni explained that few movie writers give much thought to the disabled community when writing their screen plays; there is a push to bring more awareness to writers toward inclusion.


This Documentary will be traveling the US over the next few months, it is a must see.  It is being considered for an Award in the Documentary Category- Tell your friends, and family.

 

For anyone in South Florida, there will be another screening (part of the Ft. Lauderdale Film Festival) on November 2nd.

 

This article was written by Carey Britton, Seating Specialist for Active Mobility Center. Carey can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .



Danny and Carey

Active Mobility - Inservice at Young Body Rehab

Active Mobility Center provided an Inservice for Young Body Rehab in Palm Beach on Freedom Concepts, bicycles and chill out chairs. Freedom Concepts is a manufacturer of bicycles for mobility challenged indivdiuals who are are able to use or be supported on traditional bicycles.

Freedom Concepts offers several bicycle systems for small children to adults. These systems can be customized for size, shape and abilities. These systems can be provided with caregiver stearing systems to allow the user to concentrate of movement, or the caregiver can push the bike moving the user's feet in the standard bicycle pattern.  These bikes can be operated by foot or hand. Options include shoe holders, seat and back supports, belts and harnesses, headrests, adjustable and adpative handle bars.

The Chill Out Chairs offered in mobile and rocker base, and provide an alternative, safe seating surface for children and adults with mobility challenges. 

For an Inservice or more information, please contact Carey Britton at 954-946-5793 or at cbritton@wheelchairguys.com . 

Active Mobility Center at Medtrade Orlando

Last Week (Oct 8-10) I attended Medtrade East, a yearly event where manufacturers of Home Medical Equipment present their products to equipment providers. Many new products and vendors provide a resource for offerings to people recovering, rehabing or requiring equipment for life. 

I have been attending Medtrades since the early 1990's, in a time where equipment funding was much better than today; and it showed with the event's attendance. Medtrade used to take up the entire convention center, and this year only spread 19 rows.  This proves that this industry is hurting and needs your support to ensure it is there for future generations.

This year, there were very few rehab (complex rehab) companies exhibiting. Many companies providing retail and products not affected by the Medicare competitive bidding program.

Some of the new items that I thought could help our customers were;

Environmental Controls- these controls allow a mobility challenged user to use voice ,touch, or other input to operate and control items around the home including the TV, Radio, Lights, Appliances, Door Openers, Electric Beds and more.  In the past these systems were clunky, complicated and very expensive. I was impressed a few companies using tablets and smart phones to operate home devices.

Beach Powered Wheelchairs- it was interesting to see a beach powered wheelchair for under $7000 that fits on an adaptive van lift. This will certainly offer more people access to the beach as well non paved areas.

Rifton Toileting Chair- rifton has redesigned it's toileting chair to allow attachment to multiple bases, including a tub base, and a tilt in space base. Their new design is much improved from the current version and will release shortly.

New Information Companies- there were some companies that provide some interesting information management systems that can help efficiency and the paper process.

Ram Mounts- the Ram company is making several mounts to be used on wheelchairs including, smart phone, tablet, cup holders, lap top computers, and much more.  This will allow wheelchair, scooter and powered wheelchair users to be more functional and have increase Access.

Modular Ramps- there are more companies offering more options of modular ramps. Once only available in aluminum are now available in wood and steel allowing for more options and reduced costs.

Portable Scooters- there are more companies offering foldable and compact scooter devices; some which can fit in a suitcase. This makes sense as the baby boomers are aging and need more mobility options.

ASL- Adaptive Switch Labs has some new switch options allowing powered wheelchair drivers additional options.

Pride / Quantum- has an increased number of accessories for their powered wheelchairs including cup holders, hydration systems, cell phone holders and more.

Although the show was small, with the reduced traffic attendees were able to navigate the show floor and spend more time with the vendors learning about what is new and what can help our community.

This article was written by Carey Britton, Seating and Mobility Specialist for Active Mobility Center. Carey can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com

Active Moblity Center at DisAbilities Expo 2013

This past Sunday, October 5th, was the Disabilities Expo which is the longest running expo for special needs in South Florida.  Active Mobility Center has been participating in this expo for nearly 20 years.  This years exhibit was larger, and more attended.  In addition to having equipment providers, there were several adaptive vans, many support organizations and a large number of new sports activities and groups to allow individuals with special needs an opportunity to get out there and be involved.

This year there was an all day wheelchair basket ball tournament and a runway fashion show. 

It was great to see many of our satisfied customers, and see many more individuals who were looking for education and guidance through the seating, mobility and equipment process. 

This was the first year we were able to have five members of Active Mobility Center at the exhibit to help showcase our products and services, as well to learn about other opportunities and services from other exhibiting providers.

If you didn't get a chance to get out to this event, look for this to recur next October. Carey Britton, is a Seating and Mobility Specialist with Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com

Nova South Eastern University OTs come to Active Mobility Center

On Monday, we welcomed nearly 40 second year Occupational Therapy Students for a morning Seating and Mobility training.  Each year, we host this training to provide a glimpse into the world of complex rehab and assistive technology equipment.  We divided the group in to four groups and created stations including; Insurance Coverage and the process of getting equipment, manual wheelchairs and scooters, seating and positioning, and powered wheelchairs.

With smaller groups, the OTs were able to ask questions and interact with each presentation. At the Insurance coverage session, the groups heard how complicated the process is. There are many changes in health care that make the intake, insurance verification and needed documentation a specialized process. The groups were disappointed in learning that the complex rehab process can take 2-4 months for patients to receive their permanent equipment.

At the manual wheelchair and scooter group, they learned about standard through ultra light wheelchairs, about tilt in space and recliners, and the differences in scooters. The groups were fascinated on how the process to determine the equipment was more involved that thought. They had not learned about competitive bidding and how it is negatively affecting individuals needing this type of equipment.

The groups learned about how many different types of foam cushions, contoured cushions, and molded seating types there were. Some were overwhelmed not sure how they could ever grasp how much information, and options were available.

In the powered wheelchair group, the students were shown the different types of powered wheelchairs, different ways to control them, powered seating systems and were able to trial driving these chairs; including a stand and drive permobil. 

Concluding the program we discussed how important the team (physician, therapy staff, equipment provider, individual and caregivers) is in equipment provision.  We discussed how the physician initiates and drives the process; however the PT and OT are just as important, and in some cases more important.  We discussed the importance of a good dialogue on the history of the patient, their past equipment experience, patient environment, patient dimensions, patient goals, and caregiver needs.  It is critically important to gather this information, and openly discuss the options to ensure that the patient is satisfied and that their life is improved. What is selected and provided affects that patient for a minimum of five years. 

It was impressed on these students, that if they find themselves helping someone with complex rehab, that they seek assistance if they are unsure of what best resolves the needs.  We explained that ego's should be checked at the door as the process is not for us, but the individual needing this equipment.  We suggested that once they find a position that they find a peer mentor to help them. Additionally they should find a RESNA and/or NRRTS registered provider to be part of their seating and mobility team/program.

Although many of these OTs may never be involved with Complex Rehab Equipment, they now have some basic knowledge, were give some valuable tools and have  a better respect for Complex Rehab Equipment.

This article was provided by Carey Britton, Seating and Mobility Specialist for Active Mobility Center located in Pompano Beach, Florida. Carey can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .

Quickie QM710 Power Wheelchair- Product Review

Scott Sweeney, representative from Sunrise Medical was in the office to provide an update on the Quickie QM710, Mid Drive Powered Wheelchair.  The QM710 has been marketed with Spider Track technology, where the chair has an aggressive suspension allowing it to traverse rougher terrain; including 4" curbs. Additionally the suspension dampens the ride reducing the seating displacement of the rider.  In the past year, we have seen several satisfied wheelchair users who have decided on this product to meet their needs.

New Improvements:
* New Lower Seat to Floor Height Available (16 1/2")
* Power Legrest Extension to allow standing on the footrest for transfers
* Black Wheel Option
* 12" Seat Elevator, scissor mount, and can drive at reduced speed when elevated

The QM710 is a good option for patients to consider when choosing a mid wheel drive system. 

Any comments can be directed to: Carey Britton, Seating and Mobility Specialist for Active Mobility Center. He can be reached at 954-946-5793 or cbritton@wheelchairguys.com.

Adaptive Car Seats

This week, we were fortunate to have Debra Britton provide a presentation on Car Seat Positioning Equipment. This is a regular training program at Active Mobility Center to promote and educate products to the staff, customers and professionals. If you have an interest in any specific products or services, let our office know so you can receive an invite to the programs.

Car seats are essential and mandatory for small children in motor vehicles. As children grow, or have seating and positioning needs greater than a off the shelf carseat, an Adaptive Car Seat may be necessary.  Off the shelf car seats have been crash tested as they sit so it is not recommended to add any foam/changes to these systems. Although this may work well, it changes the product and places any legal responsibility on this person in the event an accident arises.

Car Seats can be a challenge for parents with special needs, as they are not covered by Medicare, Medicaid and most insurance carriers. Medicare (Sadmerc) determined coding, and Car Seats as a transportation device and used outside the home are not covered items.  It is important to note that there are alternative funding sources that may be able to help.

Car Seats are more safe than transporting children in their primary mobility systems (ie. wheelchairs) even if transport brackets are added. Transport Brackets, also not funded through most insurance, although allow a place to strap a wheelchair into a bus or van, are not intended, as stated in their owner's manuals, with the use to be seated in the chair while it is strapped down.  Tie downs are a topic for another presentation. 

There are several products available for this purpose including products from; Columbia Medical, Convaid, SnugSeat, and Thomashilfin.  These products should not be looked at as a one product fits all, and each have certain benefits which can help a particular child.

Car Seats

The Traveller Plus EL, Carrie, Hippo, and IPS are all adaptive Car Seats. These system are similar to off the shelf systems, but are larger, and offer more padding and support to provide support and stability for a special needs child/adult.  These systems allow for a 30 pound to over 100 pound person to use them with the abililty to adjust many of them in seat depth. Some of these offer foot supports and some allow the feet to hang.

Booster Car Seats

This category comprised of the Recaro, and Pilot offer another option for support and adjustability. These systems look more like the off the self booster / car seat systems. They work really well, but have limitations in width adjustment.

More Supportive Car Seats

Recently the Carrot and Spirit systems have entered the market, offering supports similar to what you would see in a wheelchair in a car seat. For larger and involved clients needing extensive support; these systems may be the answer.

Common Questions

How do I know what product to Pick?
These products range from $500 to several thousand depending on the options and needs. Choosing a product should include the assistance of a Physiatrist, Physical or Occupational Therapist and a Seating Specialist. Since this equipment is expensive, you do not want to waste valuable resources on the wrong product.

Where do I get these products?
Most Seating and Mobility companies stock Demo's of these products and can assist you in trialing them for fit, and helping make recommendations after discussing the vehicle and assessing the patient with a therapist or physician.

Who Installs these products in my vehicle?
This is getting more difficult due to our litigious society.  There are certified people in the community who install car seats and should be consulted if after reading the directions you have any concerns or questions.

We want to Thank Debra for providing an outstanding training program and look forward to her next topic.  This article was re-written by Carey Britton, Seating Specialist for Active Mobility Center. Carey can be reach at (954) 946-5793 or at cbritton@wheelchairguys.com .

 

Active at Joe Dimagio Special Needs Fair

On Sunday September 28th, Active Mobility Center supported the Joe Dimagio/Memorial Health Care System for the sixth year.  It was a great representation of the community which offers services to the special needs community.  There were groups from Hospitals, Therapy Centers, Respite, Day Training Programs, Home Accessiblity, Financial Services, local support groups/services and ofcourse the Pirates and Mermaids. 

We saw many of our loyal customers and referral sources.  It was a great time.


Carey Britton, is the seating specialist with Active Mobility Center. He can be reached at (954) 946-5793 or cbritton@wheelchairguys.com.

New Quantum Edge with TB3 Seating



During a weekly training meetings we had our local Quantum Rep, Tim, who brought in the new Quantum Edge, mid drive powered wheelchair with a Tru-Balance 3rd Generation Powered Seating System. 

There are similarities to the Permobil seating systems, and some items that have been improved on.  There is an industry trend to make powered wheelchairs less medical and more economical.

The new seating allows for several adjustments to be made while the user is sitting in the chair. The seating can be configured with powered tilt, powered recline, powered legs and powered seat elevator.

The seat elevator is a big improvement with a scissor lift that raises the user 10". The scissor lift over a post elevator is much more durable and more sturdy when being transported in a vehicle. The new seat frame has extensive adjustability for growth/change. The arms appear to be very durable, and adjustable.  The new options including hand grips, hydration unit, cell phone holder, and back pack clips all will help users with increase independence.

The new Joystick is very streamlined, with trim that makes it look very classy. The display is color, and the horn can be programmed to be louder than in the past.

With all new systems, users can choose two standard accessories (cup holders, phone holder, accessory clip or reflectors) that will come complimentary with their new chair.

This article was provided by Carey J. Britton, Seating and Mobility Specialist with Active Mobility Center. Carey can be reached at (954) 946-5793 or cbritton@wheelchairguys.com .

Molded Seating at Active Mobility

Each week at Active Mobility Center, the staff presents on products and services to ensure staff properly educated. This week Robert Bowman and Carey Britton provided a joint presentation on Molded Seating Systems.

Molded Seating Systems are very specialized seating where an impression is taken of the patient, and where a seat and back is created that matches this shape. Molded Seating is expensive, custom, and is not for everyone.

We consider Molded Seating when a patient has asymmetrical postures that cannot be supported by off the shelf, planar seating or modular seating.  These patients are seen by a physician and ruled out for a TLSO (body brace) and where less supportive seating will not support and protect the patients posture from further decline/deformity.

There are many factors to consider when deciding on molded seating. After determining that other seating will not accommodate the patients posture; we need to determine the environment the equipment will be used, who the caregivers are, and if there will be any foreseen changes in condition.  For children and individuals who change weight/size, there is concern for molded seating to be outgrown. Additionally if there are multiple caregivers, there is concern that the patient will placed in the seating the same way each time; failure to sit in contours properly can increase pressure, or cause postural issues.

There are several types and brands of molded seating.  The most common is Silhouette, Pindot, OBSS, and Ride Designs. Each has its benefits, and after a thorough evaluation, each can be considered to best meet the goals and needs of the patient.

Molded Seating traditionally was covered in vinyl, however over the years several options and foam densities are now available. Gel, Air and Visco Foam Inserts and overlays can be used to help with pressure, posture and positioning.

Prior to molding a patient, a clinician should be involved to determine the limitations and range in anatomy to determine the best position for the patient for siting, posture, stability and function. 

Please contact Carey J. Britton, seating specialist for Active Mobility Center for any questions or information on Molded Seating or seating/positioning needs. He can be reached at (954) 946-5793 or cbritton@wheelchairguys.com  .

Krabat Pirate Water Floatation Aid

I was introduced to very interesting new product to allow people with mobility challenges to enter the watery world. The Krabat Pirate being distributed in the US by Ottobock Healthcare and is a flotation aid that supports a user with three floatation discs, a rugged rust free frame, and a stable platform. The system comes in two (2) sizes, fitting kids from 2-8 and 8-15 years of age (up to 154 pounds) and is a great way for kids with all kinds of functional issues to get in the water, to work with therapists or have fun with peers and family. 

Features and Benefits

* The Pirate gives caregivers greater freedom to interact with their child, helping them have more eye-to-eye contact and encouraging play.

* The therapist can spend time doing therapy with the child, instead of focusing on their safety.

* Head control is not necessary to use the pirate. The front float acts as a head support, and additional foam supports are available, which fit between the support element and the front float.

 

This article was provided by Carey Britton, Seating and Mobility Specialist for Active Mobility Center. He can be reached at cbritton@wheelchairguys.com or at (954) 946-5793

New From Permobil 3 G Corpus Seating

Benay and Brad

Permobil's Brad Hannan, was in the house on 09/11/2013 to present on the new 3G Corpus Seating system. Permobil was created back in 1963 by Dr. Per Uddénin in a basement in Sweeden, After massive interest, in 1966 the Permobil company was created. Permobil was founded on their Front Wheel Drive Platform, and now offers chairs in Front, Mid and Rear Wheel Drive configurations.

Fifty (50) Percent of the chairs delivered are Front Wheel Drive with Forty (40) percent Mid Drive and Ten (10) percent being Rear Wheel Drive.

Front Wheel Drive (C300, C400, C500)
* Tighter Foot Position                                   * Maneuverable               
* Better Reach by User to Environment         * Better Climbing

Mid Wheel Drive ( M300, M400, M300 HD)
* Intuitive Design-Similar to walking
* Maneuverable
* Turns on this Axis

Rear Wheel Drive (C350, Street)
* Most Powerful                 * Rugged / Outdoor Chair
* Fastest Configuration

Permobil is known for it's Power Seating offering Power Tilt, Powered Recline, Powered Legrest, Powered Seat Elevator and Power Standing. Standing capabilities which is currently only availble on the C400 Jr. and C500 Front Drive Powered Wheelchairs. These chairs allow stand and drive function. 

Adjustable Seat Frame

The 3 G Seating is now being offered and is a huge improvement from the 2G Corpus Seating. These chairs are now offered lower (17 1/2"),

with the following improvements.

* Flat Seat Pan- no longer have to modify cushions to achieve proper fit
* Anterior Tilt Option- ability to tilt seat with forward tilt to help with  
   transfers or a more active body position.
* 175 Degrees of Recine- allow more reclined position
* 5" of Sliding Back- this reduces shear and allows for 10-20 degrees of
   recline when using molded seating.
* Legrests 170 Degrees with Articulation- which allows for more reclined
   position.
* Armrests- the new armrests are more durable and allow for more adjustability.
* 2 Piece Seating- which allows the seat to be a different width than the back allowing the arm
   position to be more anatomical.

Thanks to Brad from Permobil to help provide some education on Permobil and a thorough inservice to keep up to date to better serve our customers. This article was provided by Carey Britton, Seating Specialst for Active Mobility Center. He can be reached at 954-946-5793 or cbritton@wheelchairguys.com.

Standing with Standers.....Training at Active Mobility Center

Benay Britton and Joe Navarro

This week, Benay Britton, from Active Mobility Center presented on Standing Equipment for people with mobility impairments.  Benay led the presentation saying that anyone not independently standing, and who has a mobility challenge needs to be standing. 

Benay clearly noted that anyone requesting a Standing device needs to be cleared by their physician and issued a prescription for standing.  Many people have skeletal and tendon/ligament limitations that may be aggravated or injured.

She went on to say that there are many benefits of standing from

• Builds Cardiovascular Endurance
• Improves Respiration
• Normalizes Bowel Function
• Improves Urinary Drainage
• Improves Motor Function
• Reduces the Risk of Pressure Sores
• Decreases Abnormal Muscle Tone
• Increases Circulation
• Maximizes Weight Bearing on Long Bones
• Increases Bone Density
• Increases Range of Motion

All of these helps reduces the negative affects of sitting in a wheelchair, scooter, powered wheelchair or bed.

There are many types of standing devices and they come in pediatric through adult sizes. The main types of standers are Prone, Supine, Upright and Sit to Standers. These systems come in manual or powered operation. The Prone/Supine standers come in fixed angle standers or tilt table standers. The fixed angle systems are generally for small children that are easy to transfer and where a specific angle is desired by the physician/clinician.  In many cases, it takes time to achieve more upright standing, and where an adjustable table stander is used in either prone or supine. These larger tilt tables allow the caregiver to be loaded on a flat table and then adjusted to the angle of standing tolerated or prescribed.

As the user becomes heavier and taller, transferring can be more difficult and using a table type stander. Additionally these tables for adults become very large and the user's environment may not accommodate the footprint. 

The Sit to Stand systems offer a smaller footprint, and allow for easier transfers for larger users.The

sit to stand systems can be used from sitting through standing and can be operated by the user themselves.  There are emerging studies that show increased benefits to bone density going from sit to stand. The drawback to the sit to standers is that they place force through the knees to achieve standing, and where the user needs to be able to tolerate this pressure

There are several manual and powered wheelchair standers that are commercially available. For many people standing affects their vocation, their ability to cook, access the home and interact with people.  Many times the need to stand cannot wait until one transfers into a separate standing device. 

What's Required from Insurance for Funding?

Like all Medical Equipment, a Prescription from a physician, explaining the need for standing, and most insurances now require a clinician to perform a specialty evaluation. The clinician may be a physiatrist (physical medicine doctor), a physical or occupational therapist.  These clinicians will perform a functional assessment which will determine whether a stander is medically necessary, and which type/orientation is most appropriate.  Many times it can require trialing equipment to determine what is most appropriate. Today, an ATP (Assistive Technology Provider), or SMS (Seating and Mobility Specialist) can help make recommendations once the user has been cleared for standing.

Who Funds Standers?

Technically any insurance should if medically necessity is established; however Benay explained that Medicare is very difficult to achieve approval. She explained that Medicaid, Vocational Rehabilitation, Worker's Compensation and most Private Insurances do approve these items.  Benay further explained that many insurances look at Standers and Gait Trainers as same or similar equipment, so when discussing options with one's physician and clinician; ensuring the most appropriate equipment is being provided.  Typically like all DME, there is a five year life expectancy on this equipment by the insurance provider.

This article was written by Carey Britton, Seating and Mobility Specialist for Active Mobility Center, and Complex Rehab and Assistive Technology Provider in South Florida. Carey can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com .